


Like Our Endless Numbered Days

by messageredacted



Category: House M.D.
Language: English
Status: Completed
Published: 2012-01-14
Updated: 2012-01-14
Packaged: 2017-10-29 12:38:33
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 5,587
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/319964
Author URL: https://archiveofourown.org/users/messageredacted/pseuds/messageredacted
Summary: <blockquote class="userstuff">
              <p>When House gets a patient who suffered abuse as a child, he is forced to think about how his own father influenced his life. Pairing withheld.</p>
            </blockquote>





	Like Our Endless Numbered Days

**Author's Note:**

> From the following LGBTfest prompt: #812 There were other reasons for the bad blood between him and his father: namely, men should *be* men, not *be with* men. (Story includes brief, non-explicit reference to child abuse, including sexual abuse).
> 
> My medical knowledge is a combination of Wikipedia and poetic license, so please take it with a grain of salt.
> 
> Originally written 2 May 2009.

Princeton Plainsboro Teaching Hospital in the early spring is thick with the smell of potential. Crescents of old snow melt sulkily in the corners of parking lots. Smooth-headed daffodil buds push out of the crumbling black soil. The parking lot gleams wet with melt and rain. The pavement in front of the entrance is still dyed blue at the edges with the chemical ice-melt crystals that maintenance spreads everywhere for fear of broken legs and lawsuits. It leaves licks of salt rimming the bottom few inches of his cane.

Thirteen is waiting for him by the elevators, leaning against the wall with a cup of coffee in one hand and a folder in the other. House veers left, towards the stairs, and hears her shoes clack on the floor as she strides to intercept him.

“Forty-seven-year-old male collapses in his therapist’s office and slips into a coma from diabetic ketoacidosis. You wouldn’t go up the stairs just to avoid me.” She cuts him off in front of the stairs.

“I can see how this might have slipped past the E.R. docs, but have they considered _diabetes_?” House turns back towards the elevators. Thirteen easily keeps pace with him.

“He’s never been diagnosed with diabetes.”

“Let me guess. Morbidly obese? In denial about his blood sugar because it means going on a diet? Doctors just call him borderline so they don’t hurt his feelings?” House thumbs the call button on the elevator.

“Normal weight range and normal blood sugar levels at his last checkup.” Thirteen smiles as the doors of the elevators open. “When he was admitted to the emergency room, his blood sugar was off the charts, so they treated him with insulin.”

House steps into the elevator and hesitates, not yet hitting the button for his floor. “And…?”

“He woke up from the coma, was coherent for ten minutes, and then slipped into the coma again.” Thirteen pauses for dramatic effect. “This time from severe hypoglycemia. Because he didn’t have diabetes.”

“Then he was misdiagnosed the first time. It happens all the time.” House presses the button for the second floor.

Thirteen takes a breath and goes in for the kill. “The reason he’s never been diagnosed with diabetes is because he has dissociative identity disorder. Multiple personalities. Only one of them has diabetes.”

The doors close on Thirteen’s triumphant smile.

##

Thirteen has beaten him to the office when he arrives. Foreman is making coffee at the counter. House finds himself looking automatically towards Kutner’s empty chair, then mentally kicks himself. Maybe he’ll remove the chair, although _that_ would imply that Kutner’s death is (still) affecting him and everyone would notice. That’s the problem with hiring doctors for their ability to read cause into every action.

Taub is sitting at the table, pouring over the patient’s medical files. House pushes open the door and everyone glances up.

“Tell me about our patients,” he says.

Taub lifts the medical records. “Mr. Kaufman was diagnosed with posttraumatic stress disorder thirteen years ago and dissociative identity order five years ago. He has a history of being sexually abused as a child.”

“And does this have something to do with _Misters_ Kaufman _s’s_ diabetes?” House over-enunciates the plural and watches Thirteen roll her eyes.

Taub raises his eyebrows. “It does if only _one_ of his personalities has diabetes. It must be psychosomatic.”

“Thirteen, tell Taub why he’s wrong.”

Thirteen shrugs. “If it were psychosomatic, he would be in the psych ward. Not here. When he was admitted to the E.R., his blood sugar was high and he had ketone bodies in his blood, which means it was ketoacidosis. He really was diabetic, even if he wasn’t the week before.”

“Exactly.” House uncaps a marker and writes DIABETES on the white board. “The abuse has nothing to do with this. He’s—I mean _they’re_ diabetic.”

“I didn’t say abuse had nothing to do with it. Abuse victims face all sorts of health problems,” Thirteen says.

House recaps the marker. “Taub, tell Thirteen why she’s wrong.”

“Not all of the health problems caused by abuse are psychosomatic,” Thirteen insists. “People with posttraumatic stress disorder are more likely to have dental problems, digestive problems, immune deficiencies—”

“Diabetes?”

Thirteen hesitates. “No,” she admits finally.

“But he doesn’t have diabetes,” Taub interrupts. “You can’t have full-blown diabetes _some_ of the time.”

“And you can’t go into a diabetic coma for imaginary diabetes.” House spreads his hands. “If it was ketoacidosis, he had no insulin, which means there’s something wrong with his pancreas. Give him an MRI.”

##

“So you have a patient here with posttraumatic stress disorder and you don’t think his coma has anything to do with it?” Cuddy asks dryly from the doorway of his office fifteen minutes later, which was longer than he thought it would take. Foreman demonstrated admirable restraint before running to her.

“I’m trying to see him as more than just a disorder, Cuddy,” House says in mock disappointment, his face schooled into pious sincerity. “I don’t assume that all of _your_ problems stem from your childhood abandonment issues, do I?”

She levels him a sour look. “No, all _my_ problems stem from this _pain_ in my _ass_. Someone searched my house yesterday while I was here at work. You don’t happen to know anything about that, do you?”

“Not the slightest idea.” House pushes back his chair and gets up, taking his cane from where it was leaning against his desk. “Now if you’ll excuse me, I’m going to have coffee with a pathological sense of guilt and entitlement. I call him Wilson for short.” He limps towards Cuddy, who doesn’t move out of the way.

“Call Lucas off the case, House. I don’t know why you’re stalking me but I’m not going to let it continue.” She sighs as House turns right and pushes open the glass doors into the meeting room.

“Why would I stalk you when you reveal so much of yourself right here?” House glances over his shoulder and obviously checks out her cleavage.

“Because you’re a control freak?” Cuddy suggests, following him. His pager starts beeping. “Has Mr. Posttraumatic Stress Disorder woken from his coma?”

House glances at the pager, swears, and keeps moving towards the far door. “Yes, and now he’s dying of heatstroke.”

##

The patient is House’s age but when they put him in the bathtub he moves as biddably as a child, letting them fold him into the cold water.

House stands by the door, watching as Thirteen pours cool water over the man’s head. He has curly brown hair that is fading back from the temples. It turns dark when it soaks up the water and the man immediately begins to shiver.

“It’s cold,” the patient says.

“It will help you feel better,” Thirteen says gently, wetting a cloth and folding it over the back of the man’s neck.

“I’m so cold,” the patient whispers as if he didn’t hear her. His teeth are chattering. House can feel the tightness in his own jaw. He remembers how the water can give you that tight, knotted pain in your back when your whole body is clenched against the cold; that full body shaking that you can’t even control, as hard as you try.

The man turns his head to the side and looks right at House, his eyes as gray and clear as water.

House leaves the room.

##

“New symptom,” House says, writing on the white board. “Hyperthermia. Why would his body be unable to regulate heat?”

“Malignant hyperthermia,” Taub says immediately. “He had a reaction to anesthesia. The E.R. doctors could have given him succinylcholine when he was admitted.”

“He was admitted was twenty-four hours ago. It would have happened immediately,” Foreman says. “Serotonin can cause it. If he’s taking an MAOI for his depression, it could have had a bad reaction with anything.”

“He’s not on MAOIs. He takes SSRIs, which wouldn’t have the same effect,” Thirteen reminds him. “If he somehow got his hands on his antidepressants, he could have overdosed.”

“Where would he find enough to overdose on?” Taub asks.

“Has anyone visited him?” House turns to them.

“No family, no friends, as far as we know,” Thirteen responds.

“Check the visitor logs,” House presses. “See if his therapist came to visit.”

Foreman looks confused. “You think his therapist helped him overdose?”

“He first collapsed in his therapist’s office. PTSD is sometimes treated with therapeutic glucocorticoids, which would cause the hyperglycemia the first time. If the therapist came to visit and gave him another dose, he could have developed hyperglycemia again. Hyperglycemia can cause malignant hyperthermia-like syndrome. Check the logs and make sure his therapist doesn’t come back to visit.” House picks up his coat from the back of his chair.

“Where are you going?” Foreman asks.

“I have a date.”

“Does Cuddy know you’re hiring hookers on your lunch break?” Thirteen asks.

“Are you gonna tell her?” House heads for the door.

##

“You can’t be a very good detective if Cuddy knows you were searching her house,” House says around a mouthful of reuben.

Lucas sits next to him on the park bench, chewing thoughtfully on his ham and swiss. “Unless she only assumed someone was in her house because she’s secretly hoping that you really are interested in her enough to hire a detective to stalk her. She knows you well enough to know that if you really were attracted to her, you would rather hire a detective than actually tell her.” Lucas takes another bite of his sandwich.

“But you _did_ search her house.” House doesn’t phrase it as a question.

“Well, yeah.” Lucas gives him a sidelong glance. “And I didn’t find anything, by the way. No love letters, no emails, no subscription to an online dating site. No mysterious meetings in her appointment book.”

“Unless she assumed that I would hire a detective to investigate, so she threw away any incriminating evidence.”

Lucas smirks. “Because she wants you to think that she’s not dating anyone.” His blue-eyed gaze is startlingly direct. “Because if you’re interested enough to hire a detective to see if she’s dating someone, and if she’s interested enough to make you think that she’s not dating anyone, then…”

“She’s taunting me,” House muses.

“That’s not actually where I was headed with that.”

“The only reason that an aging, relatively attractive successful single mother _wouldn’t_ be looking for a mate is if she thinks there’s no point.”

“Or maybe—”

“She has cancer,” House says firmly.

“You know, there is a fine line between brilliance and psychosis,” Lucas says. “Not that I’m one to judge, dude, I know. But—”

“Check area doctors, see if Cuddy’s been in for a consultation anywhere.” House decisively crumples his sandwich wrapper and stands. “We’ll meet again tonight.”

“Not tonight,” Lucas says. “I’ve got plans.”

“A date?” House asks dubiously.

“A date at the Blue Moon Jazz Club where I sometimes play the piano. And by sometimes I mean every Tuesday and Thursday.” Lucas shrugs. “It’s a thing I do.”

“Tomorrow then. Lunch.”

“If you’re buying.” The casual comment is offset by his warm smile.

House’s pager starts beeping. He looks down at it and frowns. “And be more careful next time,” he adds distractedly.

“Something wrong?” Lucas asks curiously.

House starts back towards the hospital. “Just a dying patient. See you tomorrow.”

##

“You were right,” Foreman says when House comes in the door. “The therapist came to visit him this morning after he woke from his second coma.”

“But his cortisol levels were normal,” Thirteen chimes in. “No glucocorticoids.”

“And then he started having seizures.” House limps over to the white board and uncaps his pen. Underneath DIABETES he writes NOT DIABETES.

“Erasing it might be easier,” Taub suggests.

“But inaccurate. They’re both symptoms.” House turns to face them. “Diabetic ketoacidosis when he enters the E.R., hypoglycemia when he’s treated with insulin, hyperthermia when he’s treated with glucose, and now seizures. Discuss.”

“Blood tests showed low sodium levels. He’s hyponatremic,” Foreman says. “His electrolytes are imbalanced.”

“Probably due to hyperglycemia,” Thirteen adds. “The glucose dilutes the sodium.”

“Which could have been caused by the glucocorticoids, except his cortisol levels are normal, and James says his therapist never gave him any,” Taub says.

“James?” House asks.

“The patient.”

“Which patient? I heard we have several.”

Taub ignores this. “He might not be diabetic at all.”

“And you made fun of me for writing ‘not diabetic’ on the board.”

“Blood tests from his first coma confirmed ketone bodies in his blood when he was first brought to the E.R.,” Taub continues. “The liver produces ketone bodies when it thinks the body is starving.”

“He didn’t look starving to me,” Foreman says dubiously.

“The Atkins diet causes ketosis and lowers pH levels. It could have caused the false reading on the blood test.”

House nods. “If it was never hyperglycemia, then what’s causing the heatstroke and the low sodium?”

“Hypertriglyceridemia could be diluting the sodium,” Foreman suggests. “Vomiting and diarrhea could dehydrate him.”

“He could just be drinking a lot of water,” Thirteen chimes in. “If he’s drinking water and dieting, it could be psychological, a way to purify his body after the abuse he suffered.”

“It’s not the abuse,” House says in irritation. He squints at the white board.

“Why not?” Thirteen asks. “It fits.”

“Just because it’s not the glucocorticoids doesn’t mean the therapist didn’t give him something.” House turns away from the white board. “There are other PTSD treatments that cause hyperthermia and hyponatremia. Thirteen, you should know this one. You probably ran into it during your bisexual orgies.”

Thirteen looks unamused. “Ecstasy isn’t a treatment for PTSD.”

“Maybe not a _legal_ treatment,” House allows. “But it used to be used in psychotherapy all the time, because it kept the patient from feeling fear when he spoke about his emotions. Maybe our patient and his doc are the experimental type. Chronic use means he eats less, so his body thinks he’s starving. He’s not diabetic so the insulin makes him hypoglycemic, and when he wakes up, his therapist-slash-drug dealer smuggles him another dose.”

“Why would he do that?”

“Long term use means his withdrawal will make him depressed and maybe suicidal. Therapist doesn’t want him to kill himself.” House glances towards movement in his office and sees Wilson tossing a paper onto his desk. “Taub, do a tox screen. Foreman and Thirteen, check James’s house for drugs.”

The crew scatters and House makes his way towards his office. When he steps in, Wilson glances up at him.

“Letter from Cuddy,” Wilson says.

House picks the paper off his desk and reads it. In Wilson’s writing it says _Do you like me? Y/N_ He raises his eyebrows at Wilson.

“Well, it’s more of a creative interpretation,” Wilson admits. “She thinks you’re stalking her because you like her.”

“I’m not stalking her.” House goes to his desk and sits down.

“I think hiring a detective to search her house qualifies.” Wilson waits for a reaction. “I know you hired Lucas. Your bank cleared a check to him.”

“Oh, so this is really about _you_ ,” House says, poking at the letter. “Checking my bank account also counts as stalking.”

“Why did you hire Lucas to stalk Cuddy if you weren’t interested in Cuddy?”

“Interested can mean so many things.” House clasps his hands on his desk. “None of which apply to how I feel about Cuddy.”

Wilson crosses his arms over his chest. “Right. Well, Cuddy’s going out for dinner tonight. By herself. At the Ca d’Oro around sevenish. She thought you might want to know.”

##

Thirteen and Foreman return after two hours. Thirteen’s cheeks are pink from the cold, and they both are holding coffees.

“No ecstasy,” Thirteen announces.

“That you could find,” House amends.

“The only drugs he’s guilty of taking are antidepressants and cigarettes,” Foreman says. “But don’t worry: we found something better.” Foreman reaches into his pocket and takes out a photograph. He holds it out to House. House takes it.

The photograph is of a man and a boy, obviously father and son. They are sitting together in a park, both smiling into the camera. They both have curly brown hair but the boy’s eyes are clear gray. It’s the patient and his father, maybe thirty years ago.

“He had this in his apartment?” House asks, frowning.

“Notice anything strange?”

“The fact that he kept a photo of his father at all?”

“His skin,” Thirteen says patiently. “He’s very pale in these pictures.”

Understanding dawns. House remembers the man in the tub, his skin tanned. “Either he spends a lot of time in a tanning bed, or—”

“Hyperpigmentation,” Thirteen finishes. “Caused by insulin resistance.”

House shakes his head distractedly. “If it were insulin resistance, he still would have had insulin in his body, which means there wouldn’t have been ketone bodies in his blood.” He taps the photograph. “His father is tanned.”

“You think it’s genetic?” Foreman asks.

“Addison’s disease. His adrenal gland doesn’t produce enough glucocorticoids. We triggered an Addisonian crisis when we treated him with insulin after he was admitted.” House shoves the photograph in his pocket.

“Why was he admitted in the first place? Addison’s wouldn’t give him high blood sugar.”

“It would if his blood sugar was low enough.” Off the blank looks, House adds, “If it was low, it could trigger Somogyi rebound. His body made him hyperglycemic in a last ditch effort to save him, and we thought that his problem was _high_ blood sugar, but it was the opposite.”

“An ACTH test should tell us if it’s Addison’s,” Foreman says. “I’ll go do it.”

“No,” House interrupts. “I will.”

##

When House comes into the room, the patient is staring up at the ceiling listlessly, looking tired. Here, in bed, he looks closer to House’s age.

“So which one are you?” House asks, wheeling a tray into the room and taking the chart off the end of the bed.

“Pardon?” The patient—James Kaufman, his file says—stares at him blankly.

House drags a chair over and sits down, glancing over the chart. “You have multiple personalities, right? Do they all have names?”

“Who are you?”

“I asked first.”

The patient frowns. “James,” he says.

“Well I know _that_. It says it right here on your chart.” House points.

“I answered your question,” James says. “Now answer mine.”

“I’m Dr. House.” House leans back in the chair, still staring at the chart.

“I saw you before. You were watching them give me a bath.”

“That’s me. I like to watch.”

The patient studies him, then looks up at the ceiling again, listless. “They tell me I might have Addison’s disease. I don’t even know what that is.”

“It means your adrenal gland isn’t working right. It’s a genetic. Your father had it too.”

The patient glances at him. “How do you know?”

House takes the photograph of the man and boy out of his pocket. “From your skin color. Addison’s causes your skin to get darker, even in places where you’re not exposed to the sun. Your father is very tanned in this picture, but you’re pale.”

James takes the photograph from House’s outstretched hand and studies it. “Where did you get this?”

“The point is, it’s a simple test to tell if you have Addison’s. If you do have it, you can treat it and live normally.”

James drops the photograph onto the side table. “Typical of him,” he mutters. “As if he didn’t cause me enough trouble.”

“I’m going to have to take some blood,” House says. James nods and lets House prepare his arm.

For a moment there is silence. James keeps his eyes fixed on the far wall, ignoring the needle. House draws a vial of blood and sets it on the tray.

“Why do you keep a picture of your father?” House asks finally.

“You think it’s weird?” James continues to stare at the far wall.

House hesitates, then says, “He ruined your life.”

“It’s not like the movies.” James glances at House. “It’s not as simple as that.”

“How could it not be simple?” House asks with more vehemence than he had intended. James looks startled, and then understanding dawns.

“Did something happen to you?”

“The man abused you intentionally and for so long that you still haven’t gotten over it, thirty years later.” House picks up the second syringe, this one filled with synthetic ACTH, and injects it into the IV.

“Life wasn’t a horror show all the time. There were times when things were almost normal. He may have been a monster but he was still my Dad.”

“Stockholm Syndrome,” House dismisses.

“Whatever you call it, it doesn’t mean that I don’t love him.”

“It means that you were _brainwashed_ into loving him.”

James shrugs. “I don’t really see a difference. It feels the same to me.” He looks at House with something uncomfortably similar to compassion. “Don’t worry, most people don’t understand it. My therapist wanted me to press charges against him but I didn’t want to.”

“Why did your therapist visit you this morning?”

“He was worried about me. He knows of my fear of hospitals. We’ve been making such progress and he was afraid I might have a relapse.”

House lifts his chin. “Progress with your other personalities.”

James eyes him. “Yeah.”

“Progress meaning that there are less of them?”

“Progress meaning that at the moment, I’m discovering new ones.” James shrugs, looking away. “I can’t work on assimilating them until I know who’s in there, you know?”

“No, I don’t know.”

“We were working with my newest alter when I got sick,” James says. “It was strange. He didn’t know anything about our past. He thought everything was normal, and he didn’t believe me when I told him about Father…” He trails off, then looks at House again. “What would you do, if you were me?”

“Why tell him the truth? Just forget that your father never existed,” House answers immediately. He glances at his watch.

“That’s impossible.” The patient shakes his head. “Even if I wanted to, I can’t forget him. He made me what I am today, whether I like it or not. All I can do is accept that and try to live the rest of my life in my own way.”

“If he made you what you are today, you can’t live your life your own way,” House says. “If you try to make yourself into something you know he wouldn’t want, that’s just as influenced by him as if you became something he _would_ want.”

“And if you don’t rebel against him because you think rebelling is a reaction to what he did, then you’re still reacting to what he did, aren’t you?” James smiles faintly. “The fact that you’re even thinking about not being influenced by him means you’re being influenced by him. There’s no way around it. It’ll just drive you crazy.”

“I guess you would know.”

James blinks at that but doesn’t seem offended. “I hated the thought of being a disappointment to him. Even after everything that he did. It didn’t matter that he had been a terrible father; I just hated to think that he would look at what I became and be disappointed. So I went to school to be an engineer, like he wanted. I listened to the same kinds of music that he liked.” James half-smiles, looking weary. “It took me years to realize that he didn’t deserve my respect. I still have trouble knowing that, but I’m working on it. I’m not trying to be everything he wanted, and I’m not trying to be everything he hated. I’m trying to be myself.”

“Your Addison’s disease was given to you by your father,” House says roughly. “It causes you to have low levels of cortisol. People with low levels of cortisol are predisposed to PTSD. If it hadn’t been for his genes, you might not have PTSD right now.”

James stares at him. House picks up the blood vial from the tray.

“I’ll be back in half an hour for the next blood test,” he says, starting for the door.

“Wait,” James says, his voice breathy. “My—chest—” His fingers curl around his shoulder and he hunches. “It—hurts—”

House returns to the side of the bed. James’ breath is coming fast and shallow. House leans over and sniffs. His breath smells fruity.

“You don’t have Addison’s,” House says tiredly, as James leans over and begins to vomit.

##

The door to House’s office swings open without a knock. House catches the tennis ball as it bounces off the wall and then looks over to see Lucas standing in the doorway.

“What are you doing here?” House throws the ball again and catches it when it bounces back. “I thought being discreet meant not showing up in my office in broad daylight.”

“Just thought I’d visit,” Lucas says, dropping into the armchair and putting his feet up on the footrest.

“What did you find about Cuddy?”

“Nothing.” Lucas tilts his head back against the chair and looks at House. “No medical problems. She’s fit as a fiddle. No reason not to date her.” His gaze has a note of challenge in it.

“I didn’t say I wanted to date her,” House says.

“No? Maybe not, but you wanted her to know that I was searching her house.”

House draws back his arm but doesn’t throw the ball. “Why would I want that?”

“You tell me. I wanted to know how she figured out that someone searched her house, so I went and asked her.”

House rubs his hand over his eyes. “I think we’re going to have to go over the definition of ‘discreet’.”

“She said that the nanny, who lives next door, noticed a strange car parked on the street, which was weird because you told me that the nanny was supposed to take the kid to a doctor’s appointment at that time. In fact, you told me specifically to go to Cuddy’s at ten a.m. because the nanny wouldn’t be there.” Lucas steeples his fingers. His fingernails are ragged and bitten and House wonders briefly what Lucas has to worry about.

“So the nanny was late for the appointment,” House says with a shrug. He throws the ball but it bounces out of reach. He swings his feet to the floor.

“There was no appointment.”

“I got it wrong. You’re the detective.”

Lucas smiles lazily. “Right. I wondered why you would want me to be caught, so I talked to your friend Wilson.”

House sighs loudly. “I didn’t hire you to investigate me.”

“Wilson said he thought that you were stalking Cuddy because you liked her. He said Cuddy thinks that too, and really, he thinks that everyone on your team probably thinks the same thing. So I thought, maybe he’s right. Maybe you like Cuddy.” Lucas pauses, tapping his fingers against his chin, and then adds, “Or maybe you want everyone to think you like Cuddy.”

“You’re right. You got me. I’m hoping everyone will think I want to bone my boss.” House leans over and picks the tennis ball off the floor.

Lucas ignores him and continues. “You’re not going to get anything else out of Cuddy, since she already thinks you’re the second coming and she lets you do whatever you want. So I thought, maybe it doesn’t have anything to do with Cuddy. Maybe she’s just the red herring so no one figures out who you really like.”

House stares at him. He opens his mouth to speak, then hesitates. “And who do I really like?” he asks finally.

Lucas unclasps his hands. “I figured it out when you said that you thought Cuddy had cancer. Of course she doesn’t have cancer. It was ridiculous to even think so. You just wanted me to keep working for you. Not because you wanted people to think you were investigating Cuddy, because everyone already knew. Because you wanted to keep having lunch every day with _me_.”

House says nothing. Lucas pauses, seeming to wait for a reaction, then continues.

“Not that you’re gay or anything—except for that one guy in med school, who isn’t exactly keeping quite about his time with the famous Dr. House.” Lucas waits again, studying his face. “This isn’t the fifties, man. No one cares if you’re bisexual. _Believe me_.”

In the continuing silence, Lucas’s expression falters. He furrows his brow. “I mean, I could be wrong…”

“You’re fired,” House says. Lucas blinks, startled.

“What?”

“I don’t need to you to investigate Cuddy anymore. Get out of here.”

Lucas hesitates a second longer, then stands. “It’s normal, Greg. No one’s going to think less of you for being yourself,” he says.

“Get out,” House says again, louder. Lucas holds up his hands in submission and steps out of the office, letting the door swing shut behind himself.

“It’s normal,” House muses out loud to the empty office, staring into space.

##

Thirteen and Taub look up at House when he comes into the patient’s room. James is resting against the pillow, his eyes half-lidded.

“His cortisol levels are normal,” House announces.

“Yes…” Thirteen says slowly, looking at him.

“PTSD causes low cortisol levels. That’s part of the problem—it effects his reaction to stress. We know he has PTSD, but his cortisol levels are normal.”

“Is it not affecting his cortisol levels for some reason?” Taub asks.

“It _is_ affecting his cortisol levels. The only way they can be normal now is if they’re usually very _high_.”

“Cushing’s syndrome,” Thirteen says in realization. “It explains the skin color changes. Cortisol counteracts insulin, so it would make give him high blood sugar, which could cause the heat stroke. But why would he have an electrolyte imbalance? Cortisol stops sodium depletion.”

“Cushing’s syndrome is a symptom, not a diagnosis,” House says. “What causes Cushing’s?”

“A tumor,” Taub says. “It would affect his hormone levels and make him stop peeing, so he would be overloaded with water.”

“And if the tumor produces ACTH, then when we gave him ACTH to test for Addison’s…” House trails off and lets Thirteen fill in the blank.

“He overdosed and developed ketoacidosis again.”

“I have cancer?” James asks groggily, looking from Thirteen to House.

“Small cell lung carcinoma,” House says, watching Thirteen’s expression drop. He looks down at the patient. “You smoke, right?”

“Yeah.” James closes his eyes. “It’s bad, isn’t it?”

“Lung cancer. You’ll need to do chemotherapy.” House watches James grimace. “You’ll be happy to know that your father had nothing to do with this.”

“Will I die?”

“We won’t know how far the cancer is until we do some testing,” Thirteen says quietly. “Our oncologist can talk to you more about your options.”

“Let Wilson know,” House says. Thirteen nods, then glances at Taub. They both leave the room.

James takes in a shaking breath, rubbing at his eyes. House sits in silence for a moment.

“It was your other personality that helped us find the cancer,” he says finally.

James says nothing. House watches him for a moment, then continues.

“The alter of yours technically didn’t have PTSD, because his childhood was normal. Since he didn’t have PTSD, his cortisol levels weren’t dragged down. The more you worked with him, the higher your cortisol levels got, until you passed out in your therapist’s office. When you woke up here, because you were afraid of hospitals, you went right back into your PTSD cortisol levels. When your therapist came back and calmed you down this morning, your cortisol levels went back up.”

“So you’re saying if I had stayed in denial of my past and never had PTSD, you would have figured out I had lung cancer much earlier.” James sucks in a trembling breath.

“I’m saying that your dad’s influence has been fighting against your own personal influence for a while now.” House shrugs. “And you won.”

##

The sun is low in the sky when House makes his way across the reception area of PPTH, heading for the doors. Wilson is just reaching the front doors but he glances back and waits when he hears House’s cane on the floor.

“Going out to dinner tonight?” Wilson asks when House reaches him.

“Don’t know yet,” House replies shortly, pushing his way through the doors.

“I talked to Lucas this afternoon. He had some interesting questions for me,” Wilson says casually. House lets the door drop on him but Wilson catches it and slips through after him.

“I fired Lucas,” House says.

“I know.” Wilson sighs. “House…” He trails off, following a step behind House as they head for the parking lot. “I think he was right.”

House says nothing. They reach his motorcycle and he slots his cane into the clip, swinging his leg over.

“I know that your father was…strict. I know he had a lot of rules for you to follow, and I know that you’re still following them.”

“My father’s dead,” House says, starting the bike.

“Which is why you should start to think about what _you_ want, instead.”

House stares at him. Wilson gives him a half-smile.

“You going to go out to dinner with Cuddy?”

House draws a breath to speak, then stops. He looks down the road, then back at Wilson.

“Do you know how to get to the Blue Moon Jazz Club?” he asks.


End file.
